[Hiring] Field Reimbursement Manager @Johnson & Johnson Innovative Medicine

Role Description

Johnson & Johnson Innovative Medicine’s Patient Engagement and Customer Solutions (PECS) team is recruiting for a Field Reimbursement Manager which will be a field-based position that will include coverage of national key accounts in the treatment of Pulmonary Hypertension.

The Field Reimbursement Manager (FRM) is responsible for serving as the primary field-based lead for education, assistance, and issue resolution with healthcare providers (HCPs), and their office staff, with respect to patient access to J&J PAH therapies. This role involves investing time (up to 20%) on-site with HCPs, assessing their education needs and facilitating collaboration and case management with various stakeholders. In addition, the FRM will virtually support case management for community practices, as needed.

Every patient’s healthcare experience is unique - shaped by personal experiences and beliefs, the presence or absence of support networks, provider and payer dynamics, and socioeconomic factors. J&J recognizes this, and wants to create an experience that is personalized, helpful, and hopeful.

Primary Responsibilities:

• Educate HCPs on product coverage, prior authorizations and appeals, reimbursement processes, claims submissions, procedures, and coding requirements of payer organizations (local payers, government payers, etc.) for core products.
• Collaborate with field support team members such as business directors and serve as reimbursement expert.
• Act with a sense of urgency to address critical access and affordability issues for patients.
• Partner with managed care colleagues to understand current policies and potential future changes.
• Conduct field-based and virtual reimbursement and access support, education and creative problem-solving aligned to FRM Rules of Engagement.
• Build strong, trust-based relationships with customers in all assigned PAH accounts.
• Manage territory logistics, routing, and account business planning.
• Maintain and grow knowledge of national, regional, local, and account market dynamics including coverage and coding requirements.
• Grow the knowledge of hub and specialty distribution channels to improve practice and patient support needs.
• Collaborate with internal J&J departments such as EPG marketing, SCG, HCC, and PECS. Serve as subject matter expert regarding education and insights on access and affordability solutions across multiple payer types and plans (i.e., Medicare, Medicaid Managed Care, Commercial).
• Execute business in accordance with the highest ethical, legal, and compliance standards, including timely and successful completion of all required training.

Market Access Expertise:

• Extensive knowledge of medication access.
• Remains current on and anticipates changes in product coverage and access knowledge, marketplace conditions, and stakeholder practices to deliver the most effective delivery of approved materials.
• Understands and adapts to the changing healthcare ecosystem to customize resourcing and messaging to HCPs and HCP staff.

Qualifications

• Bachelor’s degree (preferably in healthcare or business/public administration). An advanced business degree (MBA), or public health (MPH) is preferred.
• Minimum of 5 years of relevant professional experience.
• Account Management and/or Reimbursement experience working in the hospital and/or provider office setting, building strong customer relationships.
• Demonstrated expertise with pharmacy benefits and manufacturer affordability solutions (e.g. co-pay assistance).
• Reimbursement or relevant managed care experience (prior authorization, formulary exception and appeals processes).
• Ability to establish relationships, collaborate, and influence across a matrix organization.
• Problem-solving ability to navigate challenging access scenarios and identify solutions in a timely and efficient manner.
• Experience in working with patient support HUB services.
• Valid US driver’s license and a driving record in compliance with company standards.
• Ability to consistently maintain up to 20% travel.

Requirements

• PAH disease state experience and/or rare disease experience preferred.
• Advanced degree and/or relevant certifications in prior authorization preferred.
• Strong market access acumen as it relates to payer approval processes and business acumen preferred.
• Understanding of Medicare, Medicaid, and private payer initiatives affecting reimbursement of pharmaceutical products preferred.
• Excellent technical knowledge and expertise in payer policy preferred.
• Demonstrated competence with CRM use, Microsoft Word, and Excel preferred.

Benefits

• Vacation – 120 hours per calendar year.
• Sick time - 40 hours per calendar year; for employees who reside in the State of Colorado – 48 hours per calendar year; for employees who reside in the State of Washington – 56 hours per calendar year.
• Holiday pay, including Floating Holidays – 13 days per calendar year.
• Work, Personal and Family Time - up to 40 hours per calendar year.
• Parental Leave – 480 hours within one year of the birth/adoption/foster care of a child.
• Bereavement Leave – 240 hours for an immediate family member; 40 hours for an extended family member per calendar year.
• Caregiver Leave – 80 hours in a 52-week rolling period.
• Volunteer Leave – 32 hours per calendar year.
• Military Spouse Time-Off – 80 hours per calendar year.